CORNS

A corn is the thickened skin that forms where the shoe rubs on the toe. A hard corn forms where the skin is dry and a soft corn forms where it is moist, as between the toes.

What is the cause?

Corns are always caused by shoes; shoes usually also cause hammertoes. Shoes with high heels and a narrow pointed toe box will bunch up the toes, causing contracted joints and pressure areas in the skin. Some contracted toes are due to muscle weakness, arthritis or birth defect but most are due to tight shoes.

Beneath every corn, there is a prominence of the bone. Pressure and friction from the shoe cause the skin to thicken at this point. Corns in the foot are like calluses in the hand, ie the skin thickens to resist pressure or friction.

Unrelieved pressure on the toes can cause complications. With time, a flexible hammertoe deformity becomes a stiff hammertoe, which is more difficult to treat. The second toe may cross over the first and eventually dislocation can occur at the base of the second toe. Corns may eventually lose their ability to protect the toe and break down, forming skin ulcers. This leads to infection.

What is the treatment?

The treatment is to modify the shoes or modify the toes. The choice should be simple but it is not, because fashion, not common sense, dictates the shape of the shoe. To eliminate pressure and pain on the toes, the shoes should have a deep toe box that is shaped like the toes and made from a soft material. The heel should be low. Sandals or running shoes are the best but even dress shoes can be found that meet these requirements.

If you cannot find these shoes at a regular shoe store, a specialty shoe store will have them.

Cushion pressure spots with adhesive donut-shaped pads (corn pads). These can be purchased from any chemist shop.

Corns which become too large can be shaved down. Sponge pads can be used on tender areas. The object of surgery is to reduce the prominence of the toe where the corn is formed. Part of the bone is removed to allow the toe to lay flat in the shoe.

Surgery can correct the deformity and the type of surgery depends upon the degree of flexibility of the toe and joints involved. This surgery can be done as a day surgery procedure.